Periprosthetic femoral fractures – a comparison between cemented and uncemented hemiarthroplasties

Foster, Andrew P.; Thompson, Neville; Wong, John; Charlwood, A. Philip

doi:10.1016/j.injury.2004.07.023

Cited by 85 publications

(60 citation statements)

References 33 publications

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“…The ten patients who were re-operated due to post-operative periprosthetic fracture after a simple fall (2.3 % and 3.4 %, respectively) all had a cementless femoral stem and all occurred after a simple fall. Studies have found similar or even higher rates than ours [13][14][15][16] We found no difference in three month mortality. However, we found a statistically significant difference in one year mortality in favour of THA with DMC.…”

Section: Discussionsupporting

confidence: 74%

Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures

Bensen

Jakobsen

Krarup

2014

International Orthopaedics (SICOT)

102

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Purpose Total hip arthroplasty (THA) as primary treatment for displaced femoral neck fractures is controversial as THA is associated with higher rates of dislocation but lower rates of re-operation compared to hemiarthroplasty (HA). A dual mobility cup (DMC) design is associated with lower dislocation and re-operation rates in elective surgery. Is this also the case when used to treat displaced femoral neck fractures? The aim of this study is to compare rates of dislocation and re-operation of any kind following treatment for displaced femoral neck fractures with either bipolar HA or THA with DMC. Methods Two consecutive groups of patients treated for displaced femoral neck fractures at the Regional Hospital in Viborg in Denmark were included. In 2007-2008 171 patients (mean age 84.1 years) were treated with bipolar HA. In 2009-2010 175 patients (mean age 75.2 years) were treated with THA with DMC. Data regarding rates of dislocation and re-operation were obtained by retrospective review of medical records. Results We found a statistically significant difference regarding rates of dislocation and re-operation of any kind in favour of THA with DMC. Dislocation occurred in 25/171 patients [95 % confidence interval (CI) 9.3-19.9 %] treated with bipolar HA and 8/175 patients (95 % CI 1.5-7.7 %) treated with THA with DMC (p=0.002). Re-operations were required in 32/171 patients (95 % CI 12.9-24.6 %) treated with bipolar HA and 16/175 patients (95 % CI 4.8-13.4 %) treated with THA with DMC (p=0.01). Conclusions Our findings indicate that THA with DMC is superior to bipolar HA following treatment for displaced femoral neck fractures in regard to rates of dislocation and re-operation.

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Section: Discussionsupporting

confidence: 74%

Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures

Bensen

Jakobsen

Krarup

2014

International Orthopaedics (SICOT)

102

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“…[11][12][13][14] There is evidence showing no increased mortality and, in fact, decreased morbidity with cemented versus uncemented hemiarthroplasty. 15 A review of the Cochrane database did not show increased morbidity or mortality with the use of cemented arthroplasty for #NOF.…”

Section: Discussionmentioning

confidence: 99%

Total hip replacement for the treatment of acute femoral neck fractures: results from the National Joint Registry of England and Wales at 3-5 years after surgery

Stafford

Charman

Borroff

et al. 2012

annals

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INTRODUCTION This paper describes, for the first time, the outcomes of patients undergoing total hip replacement for acute fractured neck of femur (#NOF) as recorded by the National Joint Registry of England and Wales (NJR). METHODS In the NJR we identified 1,302 of 157,232 Hospital Episode Statistics linked patients who had been recorded as having a total hip replacement for acute #NOF between April 2003 and November 2008. RESULTS The revision rate at five years for fully uncemented components was 4.1% (95% confidence interval [CI]: 2.2-7.3%), for hybrid it was 2.2% (95% CI: 0.9%-5.3%) and for fully cemented components 0.9% (95% CI: 0.4-2.0%). Five-year revision rates were increased for those whose operations were performed via a posterior versus a lateral approach. The Kaplan-Meier estimate of 30-day mortality was 1.4% (95% CI: 1.0-2.4%), which is over double the 30-day mortality rate for total hip replacement identified by the Office for National Statistics. The mean length of stay was also increased for those undergoing total hip replacements for #NOF compared with non-emergency indications. CONCLUSIONS Our data suggest that total hip replacements for acute #NOF give comparable results with total hip replacements for other indications.

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“…Cementing the femoral stem does not necessarily improve outcome. [6][7][8][9][10] Cementless arthroplasties are associated with mid-thigh pain and a higher risk of periprosthetic fractures, whereas cemented arthroplasties are associated with a higher risk of cardiac and respiratory complications secondary to the toxic effect of cement or pulmonary embolisation of bone marrow contents and methylmethacrylate particles. [11][12][13][14][15][16] This study compared cemented versus cementless bipolar hemiarthroplasty in terms of operating time, blood loss, pain, functional outcome, morbidity, and mortality.…”

Section: Introductionmentioning

confidence: 99%

Cemented versus Cementless Hemiarthroplasty for Femoral Neck Fractures in the Elderly

Krishna

2014

J Orthop Surg (Hong Kong)

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Purpose. To compare cemented versus cementless bipolar hemiarthroplasty in terms of operating time, blood loss, pain, functional outcome, morbidity, and mortality. Methods. Medical records of 207 patients aged ≥60 years who underwent bipolar hemiarthroplasty for displaced femoral neck fracture using a cemented (n=96) or cementless (n=111) prosthesis were reviewed. Postoperative thigh pain, ambulatory status, and complications were assessed. Results. The cemented group had significantly longer operating time (p=0.017) and greater intraoperative blood loss (p=0.024). Postoperative thigh pain was significantly higher in the cementless group (p=0.023). Conclusion.Cementless hemiarthroplasty is preferred over cemented hemiarthroplasty because of reduced operating time and intra-operative blood loss. It was associated with increased postoperative thigh pain, but functional outcomes, complications, Cemented versus cementless hemiarthroplasty for femoral neck fractures in the elderly Zhaowen Dennis Ng, Lingaraj KrishnaDepartment of Orthopaedic Surgery, National University of Singapore, National University Hospital, Singapore Address correspondence and reprint requests to: Dr Zhaowen Dennis Ng, Department of Orthopaedic Surgery, National University of Singapore, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074. Email: dnzw07@gmail.com Journal of Orthopaedic Surgery 2014;22(2):186-9 and mortality were similar between the 2 groups.

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Periprosthetic femoral fractures – a comparison between cemented and uncemented hemiarthroplasties

Cited by 85 publications

References 33 publications

Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures

Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures

Total hip replacement for the treatment of acute femoral neck fractures: results from the National Joint Registry of England and Wales at 3-5 years after surgery

Cemented versus Cementless Hemiarthroplasty for Femoral Neck Fractures in the Elderly

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